Validation of an all-source composite mortality endpoint in the US population

To validate ConcertAI’s All Source Composite Mortality Endpoint (ASCME), which combines information from electronic health records, obituary, government and administrative claims. To compare overall survival (OS) estimates using ASCME versus a National Death Index (NDI) dataset across clinical cohorts.

Retrospective study of oncology real-world data, reporting sensitivity, specificity, positive predictive value and negative predictive value compared with the NDI standard, plus 5, 7 and 15-day concordance on date of death. Additional comparisons included Kaplan–Meier OS measured by ASCME versus NDI. Data sources included ConcertAI’s Patient360™ dataset, and a 2022 annual finalized NDI dataset. The sample included cancer patients prevalent from 1 April 2014 to 31 December 2022 in any of 10 of ConcertAI’s solid tumor-specific datasets.

Of 32,358 study patients, 14,241 (44.0%) were deceased as defined by an NDI true match. Sensitivity was 95.0% overall (an incremental 5.2% due to claims) and ranged from 92.7% to 97.8% across clinical cohorts. Overall specificity was 96.5%, with positive predictive value and negative predictive value of 95.8% each. ASCME's 5-day concordance was 97.9%, with 7-day and 15-day concordance of 98.2% and 99.1%, respectively. ASCME and NDI-based median OS estimates differed by 12.2 days among non-metastatic cohorts, and 4.5 days among metastatic cohorts.

Results show ConcertAI’s ASCME death indicator to provide high completeness and accuracy, producing OS estimates largely indistinguishable from NDI-based estimates. Findings show the importance of including claims in composite mortality indicators and demonstrate the value of real-world data in assessing OS outcomes in metastatic and non-metastatic cancer patient populations.